Care at the End of Life

For generations it was common to live out your last days and die at home. With advancements in medicine, there was a modern shift in how and where care was provided. End of life care began to be littered with emergency room visits, medical tests, ICU doctors and intensive treatments. The landscape of death moved from the home to the hospital. While this is still common, more and more people are choosing to reverse this trend by trading the institutional care setting for a death at home.

When it comes to death, there is very little that we have control over as human beings; however, one way that we exercise our control is to shape our environment. This sense of choice and control over the place where we die has become an important factor in shaping the decisions we make about healthcare. As individuals have transitioned home, end of life care has mimicked this transition.

End of Life Care: Understanding When to Engage in Services  

End of life care is really executed by a team of individuals that may include doctors, hospice aides, therapists, home care caregivers, counselors, and family. Hospice and home care are two different but complimentary services that together act as a support system of care for aging adults and their family. Some of the key differences between hospice and home care services are in their duration, scope of care, and how they are paid for.

  • When is hospice care needed? Hospice services are engaged when an individual is actively dying either from a terminal illness or natural causes. The focus of care for the hospice nurse visiting the home is centered on comfort. Their unique duties include administering and providing palliative medications, and guiding the family through the dying process. It wasn’t until 1986 that Medicare hospice benefit was made permanent by congress. Though relatively new, for those that qualify, hospice services are covered by Medicare. Throughout the dying process, a hospice nurse makes intermittent visits to the home to check on the individual. While the hospice nurses and aides are on-call 24 hours a day, they are not consistently present in the home to provide the hour by hour care needed. The responsibility for 24-hour care such as feeding, toileting, bathing, dressing, and general presence are not covered by hospice and generally fall to the family. When family are not able to provide the round-the-clock care that is necessary during the final stages of the dying process, home care services can step in and fill the gap.
  • When is home care needed? With advancements in medicine we have seen a huge increase in life expectancy. With this new found longevity, we are seeing an extension of the aging process. As a result, assistance with a variety of everyday activities is often needed long before the dying process begins. Private in-home care caregivers can be used to support an individual to both age well and die well according to their values and wishes. The focus of home care is adaptable to facilitate the changing needs of an aging adults. While services might begin with simple activities such as meal preparation and transportation their focus can seamlessly extend to provide personal end-of-life care. It is a common myth that Medicare pays for long-term care; however it does not. Long-term care services such as in-home care are private pay services that can be supplemented with long-term care insurance.

The Very Best in End-of-Life Care  

For individuals choosing to die at home, it is common that their families shoulder the responsibility of providing or finding appropriate care. Balancing the emotional and logistical aspects of end-of-life care can be overwhelming. From coordinating a transition home from the hospital to providing intensive personal care, families are often ill-equipped to meet the responsibilities of end-of-life care. They want the want the best for their loved one, but are often are faced with the steep learning curve of elder care. This is where the professionals come in. We feel so strongly about having options in care at all points of life, we built it into our name. At Sound Options, end-of-life care begins with exceptional professionals who are equipped to provide the compassionate care that families wish they could provide themselves. We understand the role of the home environment in dying with dignity. Being surround by familiar objects and photos that tell your story is an important aspect of reviewing and letting go of a life well-lived. Our caregivers are able to curate the home environment from the bedside and beyond by serving individuals through personal care, housekeeping, home management, and companionship. Through in-home care services, family are allowed to just be family while we take care of the logistics of care. For more information about caregivers for end-of-life care, visit us at or give us a call at 800.628.7649.  

Published on March 26, 2014.